肠内肠外联合营养支持对肝癌患者术后肠道恢复、营养指标及肝功能的影响

Effects of Enteral and Parenteral Nutritional Support on Intestinal Recovery,Nutritional Indexes and Liver Function in Patients with Liver Cancer After Operation

目的探讨肠内肠外联合营养支持对肝癌患者术后肠道恢复、营养指标及肝功能的影响。方法前瞻性纳入2021年2月至2022年3月收治的82例肝癌手术患者,根据随机数字表法分为两组,对照组(41例)接受肠外营养支持,观察组(41例)接受肠内联合肠外营养支持,两组均治疗7 d,比较两组肝功能、营养指标、免疫功能状态以及肠道恢复情况。结果观察组胃肠反应评分、腹胀痛评分、肠鸣音评分低于对照组,胃肠道功能恢复时间短于对照组(P<0.05);治疗7 d后观察组白蛋白、前白蛋白、总蛋白、直接胆红素(DB)、总胆红素(TB)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、CD8^(+)、CD4^(+)、NK细胞改善情况优于对照组(P<0.05)。结论在肝癌患者术后进行肠内肠外联合营养支持,能够有效减轻肝缺血-再灌注损伤,利于改善术后营养状态和免疫功能状态。

Objective To explore the effects of enteral and parenteral nutritional support on intestinal recovery,nutritional indexes and liver function in patients with liver cancer after operation.Methods A total of 82 patients with liver cancer were treated prospectively from February 2021 to March 2022 were divided into two groups according to the random number table method.A total of 41 cases in the control group were treated with parenteral nutrition support,and 41 cases in the observation group were treated with enteral combined parenteral nutrition support.After 7 days of treatment,the liver function,nutritional indexes,immune function and intestinal recovery were compared between the two groups.Results The gastrointestinal reaction score,abdominal distension pain score and bowel sound score in the observation group were lower than those in the control group(P<0.05).The recovery time of gastrointestinal function in the observation group was shorter than that in the control group(P<0.05).After 7 days of treatment,the improvement of albumin,prealbumin,total protein,direct bilirubin(DB),total bilirubin(TB),lactic acid dehydrogenase(LDH),aspartate aminotransferase(AST),alanine aminotransferase(ALT),CD8^(+),CD4^(+)and NK cells in the observation group were better than those in the control group(P<0.05).Conclusion Enteral and parenteral nutritional support in patients with liver cancer after operation can effectively reduce liver ischemia-reperfusion injury and improve postoperative nutritional status and immune function.